Abstract
Objectives: Fiji could be the first country to eliminate tuberculosis. To inform this strategy, we aimed to identify how many GeneXpert (R) machines are required to enable over 90% of Fijians to be within one-hour easy access. Methods: We used Geographic Information System (Quantum GIS; QGIS), OpenStreetMap and population data (Kontur) to map possible facilities in relation to QGIS generated 60-min drive-time isochrones, with correction for missing road data. For outer islands, we calculated a distance to nearest hub operation. Results: The solution comprised 24 GeneXpert (R) machines, allocating 7 GeneXpert (R) to Viti Levu, 6 GeneXpert (R) to Vanua Levu and 11 to other islands. This resulted in 827,810 people, 93.6% of Fiji's population, being within 1 h of a machine. Twenty-one thousand four hundred seventy-nine people on outer islands were an average of 43 km by water from the nearest facility. Conclusions: We conclude that over 90% of Fijians could be within an hour of a GeneXpert (R) machine with placement of 24 machines.